Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

The Produce Traceability Initiative: FDA May Slap RFID Tags On Your Veggies

No Comments »

How cool would it be if we were able to scan a tomato at our local supermarket and see where it was grown and when it was picked? This technology may not be far away. A few years ago food producers in the US and Canada joined together to create the Produce Traceability Initiative. The system uses a bar code to track fruits and veggies from field to fork. Right now it is voluntary to participate, but lawmakers are looking at the Food and Drug Administration (FDA) passing it into law.

If it passes, the companies selling food in America will have to adopt a tracking system that will be able to track food from farmer to the field, to the picker, the packer, the shipper, the wholesaler, and the shop. All of this would happen within two days if a case of food poisoning is reported. Read more »

This post, The Produce Traceability Initiative: FDA May Slap RFID Tags On Your Veggies, was originally published on by Brian Westphal.

Patrick Swayze Has Passed Away From Pancreatic Cancer

No Comments »

patrick-swayze-nowPatrick Swayze, the popular actor perhaps known best for his role in the 1987 hit movie “Dirty Dancing,” died today of pancreatic cancer. My thoughts are with his family in this time of grief.

Pancreatic cancer is among the more deadly forms of cancer. I asked GI oncologist, Heinz-Josef Lenz, M.D., professor of medicine and professor of preventive medicine in the Division of Medical Oncology at the Keck School of Medicine at the University of Southern California, to explain why that’s so.

Dr. Val: Why is pancreatic cancer so much more deadly (i.e. less treatable) than many other forms of cancer?

Dr. Lenz: Unfortunately we don’t have very effective drugs for pancreatic cancer, which makes it one of the deadliest cancers of all. The median survival is about 8 months with metastatic disease. Even when the tumor is successfully removed there is a very high risk for tumor recurrence. We need more funding to better understand the risk for pancreatic cancer and identify and develop more effective therapies.

Dr. Val: Can you describe the typical course of metastatic pancreatic cancer?

Dr. Lenz: Unfortunately, the 5 year survival rate for pancreatic cancer is only 15 to 20%. The average survival after diagnosis is 12 to 19 months. The best predictor of long term survival is if the tumor is found and removed before it reaches 3 cm in size. Patients with metastatic pancreatic cancer are usually treated with a combination chemotherapy consisting of gemcitabine, tarceva, xeloda or oxaliplatin. However the response rates are (despite using aggressive combination therapies) low. Large clinical trials recently did not show any benefit from erbitux or avastin, again demonstrating that pancreatic cancer therapy is a difficult clinical challenge.

Dr. Val: Are certain populations at higher risk than others for pancreatic cancer?

Dr. Lenz: Age is the most important risk factor for this cancer. It is most common in individuals over age 50 and increases in frequency with age. Black men and women are slightly more likely to get pancreatic cancer (though the reasons for this are unclear), and men are slightly more likely than women to get the cancer. Other risk factors are smoking, diabetes, and obesity.

Dr. Val: If you suspect that someone is “high risk” for pancreatic cancer, what tests should he/she have?

Dr. Lenz:  Patients with a genetic predisposition for breast cancer known as BRCA are also at higher risk for pancreatic cancer. There is also a familial form of pancreatic cancer. These high risk families are being followed up with specific screening plans. However there is not a reliable test for pancreatic cancer. Imaging with CT or MRI can miss pancreatic cancer and there is no reliable blood marker. The most common used is CA 19-9, which can be used for monitoring and diagnosis but is not elevated in all patients.

Dr. Val: What if the cancer is caught very early? Does that increase likelihood of survival?

Dr. Lenz: Absolutely. The best chance of survival is when the cancer is limited to the pancreas, and is surgically removed before it reaches a size of 3 centimeters. There are certainly people who have been cured this way, but unfortunately it’s very rare to catch the cancer at such an early stage since it usually has no symptoms until it’s quite advanced.


There is a wonderful advocacy group for those whose lives are touched by pancreatic cancer: PanCAN. One of PanCAN’s founders, Paula Kim, is a friend of mine and was inspired to create the organization after her dad was diagnosed with pancreatic cancer in 1999. At that time there was very little advocacy for this deadly disease. PanCAN helps people with pancreatic cancer find help and support.

Ultrasound Image Of Baby Girl Sucking Her Thumb Changes Parents’ Minds About Aborting Her

No Comments »

via The ultrasound that saved a baby girl’s life – guest post by Dr Linda M. Lee at Originally posted at Dr. Linda’s Life Lessons

“We already have two girls at home and we want a son. We have too many girls.” My eyes welled with tears as I thought of the fate of this poor, helpless baby who had no voice, no rights, and who was about to be “attacked just because she was female.”

I pulled the ultrasound image from the chart and my heart quickened. The image was of the perfect outline of the precious little baby girl sucking her thumb. The timing of the ultrasound image was perfect.

I proudly showed them the image, and the look and emotion on their faces changed.

“That is our baby?” they inquired. “We didn’t think it had that much form, and she is sucking her thumb already?”

Read the rest of the post here or here.

Score one for ultrasound!

*This blog post was originally published at scan man's notes*

Amylopectin Powder’s Amazing Ability Top Stop Hemorrhaging Fast

No Comments »

Michael Kilbourne and colleagues recently published an article entitled “Hemostatic Efficacy of Modified Amylopectin Powder in a Lethal Porcine Model of Extremity Arterial Injury”( Annals of Emergency Medicine 2009;53:804-810). The purpose of the study described in this article was to investigate the blood-stopping ability of a modified amylopectin powder in an animal (pig) model of severe limb bleeding created by an injury to the femoral artery.

Following creation of the injury, animals were treated either with regular gauze with manual compression or with specially modified amylopectin powder and manual compression. Some of the endpoints measured in the study were total blood loss, survival, and time to bleeding cessation.

Post-treatment blood loss in the amylopectin powder-treated group was much less (approximately 0.275 liter) than in the gauze group (approximately 1.3 liters). Bleeding was stopped in approximately 9 minutes in the amylopectin group, and never stopped in the gauze group. 100% of the amylopectin animals survived, and none of the gauze animals survived.

While this study was directed to improve care for victims of major trauma (including wartime situations), the applicability to situations in the outdoors is direct. Many blood-stopping bandages have come to the civilian market, and they are quite useful. I carry them with me whenever I’m going into the wilderness, and often when I cover athletic events as the team doctor. They’re useful for nosebleeds and cuts, not just for severe injuries. Some of the product names include HemCon Bandage, QuickClot, BleedArrest, QR, Celox, and BloodStop. There will undoubtedly be improvements in these products, in particular the delivery systems, be they bandages or powders.

image courtesy of

This post, Amylopectin Powder’s Amazing Ability Top Stop Hemorrhaging Fast, was originally published on by Paul Auerbach, M.D..

Medicare & Private Health Insurance: Monkey See, Monkey Do

No Comments »

File this under utterly predictable:

Aetna tightens payment policies on hospital errors – Modern Healthcare (sub req)

Aetna has established new, tighter policies dictating when it will and will not reimburse for medical care related to errors made by providers.

Under the policies, Aetna has broken errors into two categories: “never events”—three events involving surgery: wrong patient, wrong site and wrong procedure—and 25 serious reportable events as defined by the National Quality Forum. Providers will not be reimbursed for a case involving one of the three never events, under the new payment policy. Of the 25 events, eight will be reviewed by Aetna to determine whether reimbursement should be withheld. The rest of the events will also be reviewed under Aetna’s new policy, but they will not be considered eligible for adjustments to reimbursement, the spokeswoman said.

This of course follows on the heels of Medicare’s decision not to pay for such events. The good news is that, as far as I can tell, Aetna has not extended the policy as far as Medicare has. Medicare, you may recall, also decided not to pay for certain (arguably) preventable conditions, such as foley-catheter-associated urinary tract infections, and surgical wound infections. Aetna, at least for the moment, is limiting its policy to the more black-and-white “never events” as defined by the National Quality Forum: items such as wrong-patient surgery or death due to contaminated medications.

I mention this not to rail against these standards or against the notion of incentivizing hospitals financially to avoid errors, but to highlight how rapidly and directly Medicare policies are aped by private insurers to the point that they become industry standards.

*This blog post was originally published at Movin' Meat*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »